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Application Processing Changes for ACA Implementation

Application Processing Changes for ACA Implementation. Fall 2013. Presented by the Self-Sufficiency Training Unit. ACA Implementation. Oregon is ready to implement changes in the way we offer medical coverage to our customers

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Application Processing Changes for ACA Implementation

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  1. Application Processing Changes for ACA Implementation Fall 2013 Presented by the Self-Sufficiency Training Unit

  2. ACA Implementation Oregon is ready to implement changes in the way we offer medical coverage to our customers This webinar will explain the immediate changes we will be supporting, including: • Guidelines for daily work • Interacting with our customers • Collaboration with OHA and Cover Oregon

  3. After Implementation Medical cases will be carried by the OHA Statewide Processing Center (5503), APD and AAA DHS will continue to determine REFM medical eligibility Cover Oregon will help customers compareand enroll into insurance that fits their budget

  4. Requests Prior to October 1 Medical applications with a DOR prior to October 1 will be processed in the branch using current eligibility rules • This includes cases that may be in pend status Once eligibility is established, and a separate P2 medical case is open, transfer the medical case to 5503

  5. Requests After October 1 Effective witha DOR of October 1, 2013 and later, DHS will do medical differently Eligibility for OCCS medical programs: BCCTP, CEC, CEM, CHIP, EXT, HKC, MAA, MAF, OPC, OP6, OPU and SAC will be determined by staff at 5503

  6. Deferment of Renewals Renewals occurring October 2013 – March 2014 will be deferred out 6 months (excludes some populations)

  7. Case Transfers SSP, OHA and APD will work together to complete all case transfers

  8. Medical Cases in SSP • All OCCS medical cases in SSP branches will be transferred to 5503 • QMB/OCCS combination medical cases will be transferred to 5503 (example: a pregnant woman who also qualifies for QMB) • No further action is required by the branch • Any APD medical cases currently in an SSP office will need to be transferred to the local APD or AAA office • A transfer notice needs to be sent

  9. APD Medical Cases All OCCS medical cases in APD branches will be transferred to 5503 • This includes QMB/OCCS medical combination cases (example: a pregnant woman receiving QMB) • No transfer notice will be required

  10. Medical Removal from the FSM The Medical Chapter of the FSM will be removed on September 30, 2013 in preparation for the new MAGI medical eligibility processes that will begin October 1, 2013 The Medical Chapter will remain available on the FSM Archive site

  11. Application changes Collaborating with 5503 New ways to receive medical Coming Up:

  12. Oregon Health Plan Brochure

  13. Medical Requests Received After October 1 If a request for medical is received in an SSP office on, or after October 1, the branch will: • Complete the Date of Request for OCCS Medical Request form • Fax to: (503) 373-7493 • Or email to: : 5503 Case Transfers

  14. Medical DOR form for OHA-5503

  15. Medical Requests If a request for medical is received in an SSP office, the branch can: • Provide the applicant with a date stamped 7210 application • The application can be completed and mailed by the customer to 5503 • or the branch can email or FAX the application to 5503 Fax: (503) 373-7493 • Email: 5503 Case Transfers Direct the applicant to www.coveroregon.com

  16. TANF and EXT Transition Clients transitioning off of TANF due to an increase in income will remain eligible for EXT Indicate changes on the Date of Request for OCCS Medical Program Benefits form

  17. New MSC415F 10/01/13 revision will exclude medical questions

  18. Paper Application Online New 7210 (Paper and Online)(Effective 10/01/13) Compatible with all browsers

  19. New Doorways into Medical • SNAP Based Medical • Pended Presumptive Referrals • Parents with Medically Eligible Children • Standard Reservation List

  20. Fast-Track Enrollment SNAP-Based Medical and Eligibility for Parents of Medically Eligible Children will be on a “fast-track” enrollment for the new January 2014 programs Your clients may receive a letter of consent Date stamp – fax or email to 5503

  21. Standard Reservation List OHP Standard Reservation List requesters will be mailed a letter in mid-October regarding new health care options for January 1, 2014

  22. Case Separation Coming up:

  23. Separation Basics

  24. Separation Basics • When creating separate CM cases: • Open two sessions of DHR • Determine the type of combo case • Verify there are no duplicate cases • Follow the steps to separate and transfer the newly created case

  25. Using CASEM • From Webm,Find • Select the CM case, F22 for CASEM

  26. CASEM • Place a “Y” in the Srce field • Choose individuals to transfer • F14

  27. New CM Case

  28. Separating Combo Cases

  29. TADVS/Medical Combo

  30. New Medical Case Actions

  31. New Medical Case Actions DO NOT SAVE YET!

  32. Original Combo Case Actions DO NOT SAVE YET!

  33. Saving your new cases • Verify all information is correct on both cases • First! • Press F9 twice on your original combo case • Second! • Press F9 twice on your newly created medical stand alone case

  34. JPI/Medical Combo

  35. New Medical Case Actions DO NOT SAVE YET!

  36. Original Combo Case Actions DO NOT SAVE YET!

  37. Saving your new cases • Verify all information is correct on both cases • First! • Press F9 twice on your original combo case • Second! • Press F9 twice on your newly created medical stand alone case

  38. ERDC/Medical Combo

  39. New Medical Case Actions DO NOT SAVE YET!

  40. Original Combo Case Actions DO NOT SAVE YET!

  41. Saving your new cases • Verify all information is correct on both cases • First! • Press F9 twice on your original combo case • Second! • Press F9 twice on your newly created medical stand alone case

  42. TANF/Medical Combo

  43. New Medical Case Actions DO NOT SAVE YET!

  44. Original Combo Case Actions DO NOT SAVE YET!

  45. JOBS Exemption Coding Errors • If you receive this error on the original combo case “Exempt reason code P requires DUE N/R or CH/NO under 2 years” Add the DUE date back onto the TANF only case.

  46. Saving your new cases • Verify all information is correct on both cases • First! • Press F9 twice on your original combo case • Second! • Press F9 twice on your newly created medical stand alone case

  47. QMB/OCCS Medical Combo Notice that recipient is only receiving QMB. If recipient was receiving QMB and OCCS medical, transfer whole case to 5503.

  48. QMB/OCCS Medical Combo

  49. New QMB Case Coding DO NOT SAVE YET!

  50. Original Combo Case Actions DO NOT SAVE YET!

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